PHOENIX — Facing a surge of patients, COVID and otherwise, the state’s largest hospital chain is providing care in hallways, waiting rooms and even ambulances during surges and is making “day-by-day decisions’’ on admitting patients for elective surgeries, its chief clinical officer reported Wednesday.
The announcement from Dr. Marjorie Bessel said that a quarter of all beds at Banner Health facilities are occupied by patient with COVID-19. That figure parallels what other hospitals in Arizona are reporting to the Department of Health Services.
That is still less than at the peak last year when COVID patients filled more than half the beds.
But Bessel said part of what’s different now — and what is causing complications — is “an unseasonably high volume of non-COVID patients.’’
“At this time it is very difficult to predict when this surge will subside,’’ she said.
And there’s something else. Bessell said many patients are those who delayed care during the past 17 months due to the pandemic.
“They are now seeking care for illnesses and medical issues that have become more severe,’’ she said.
“We are seeing patients with advanced heart issues, late-stage cancer and injuries that require more extensive surgical and procedural care to correct,’’ Bessel explained. And that is on top of the COVID patients.
“Please remember these COVID patients require much more attention and care,’’ she said.
That, in turn, relates to what is coming in the door — and how and where treatment can be provided — as Bessel was asked where care is being provided.
“At this time, we remain open and a safe place for care,’’ she responded. “And yet, it is requiring us to deliver care in ways that are different than our absolute usual and normal.’’
So what does that involve?
“Decisions on how best to care for patients are made on an hour-by-hour basis,’’ a hospital representative said later when pressed for specifics. “Care provided in hallways, ambulances and waiting rooms can occur during our surges.’’
But the hospital said it does not gather or track data related to any of that.
Holly Ward, marketing and communications director for the Arizona Hospital and Healthcare Association, said the problem is not unique to Banner.
“We hear reports of a large amount of ‘patient holds,’ meaning patients are waiting in the emergency department or an overflow unit awaiting an inpatient bed,’’ she said.
All this is part of a larger trend in COVID-19.
Bessel said most of the patients are in the 20- to 60-year-old range. That, she said, is in sharp contrast with early in the pandemic when it was seniors — those 65 and up — filling up the beds.
“We believe that this, of course, is directly related to the vaccination rates of those that are in that age group of 65-plus,’’ she said, who were early priorities and have a rate that is “quite high.’’ And she used that factor to prompt others to roll up their sleeves.
In the meantime, Banner — and other hospitals — have to deal with patients filling up beds. And that goes to the question of the ability of patients to get “elective surgeries.’’
Last year, facing high occupancy rates at hospitals, Gov. Doug Ducey ordered the facilities to halt elective procedures to preserve bed space for patients with COVID and other ailments that required immediate care.
Ward said at the time that the hospitals agreed with the governor’s order.
“However, it is having dire financial consequences,’’ she said, with hospitals losing revenue from more lucrative procedures such as knee surgeries and hip replacements. “That’s a lot of financial bleeding that’s happening.’’
Ducey subsequently rescinded his order. But now hospitals officials may find they have to take the same measures on their own.
“It is possible that we would need to curtail elective surgeries and procedures in the future,’’ Bessel said, whatever the financial considerations.
“Absolutely, those are a revenue source for all health care systems,’’ she said. “Banner Health is no different than any other health care system.’’
Still, Bessel said, curbing those procedures is not a move Banner wants to make.
“Our intent, especially as a not-for-profit organization providing a lot of care in the states where we operate is to be available for everybody,’’ she said. “The financial impact of not being able to provide elective surgeries does not go into any of our decision making.’’
What does affect those decisions, Bessel said, is the capacity of the hospital to provide care for those elective patients while also dealing with the surge of COVID patients.
“So while it is financially disadvantageous to not have surgeries be offered, I want to make sure that it’s very clear that that is not the driving decision maker for us,’’ she said.